Chapter 4: The Abdomen Flashcards
1
Q
Cylindrical chamber between thoracic and pelvic cavities
A
abdomen
2
Q
- forms the opening to abdomen
- Closed by the diaphragm
A
inferior thoracic aperture
3
Q
continuous with the pelvic cavity at the pelvic inlet
A
deep abdominal wall
4
Q
found in the abdomen
A
peritoneal cavity
5
Q
superficially, is the superior margin of the leg
A
abdominal wall
6
Q
either suspended in the peritoneal cavity by mesenteries or positioned between the cavity and the musculoskeletal wall
A
abdominal viscera
7
Q
Houses the major elements of the gastrointestinal system, the spleen, and parts of the urinary system
A
abdomen
8
Q
under the domes of the diaphragm
A
Much of the liver, gallbladder, stomach, and spleen
9
Q
helps change the volume of the thoracic cavity during breathing
A
abdominal wall
10
Q
abdominal wall accommodates the expansion of the thoracic cavity
A
inspiration
11
Q
abdominal wall contracts to assist elevating the diaphragm
A
expiration
12
Q
- When the diaphragm is fixed and air is retained in the lungs via a closed laryn
- Aids in voiding contents of bladder, rectum, uterus (giving birth)
A
Changes in intraabdominal pressure
13
Q
Consists partly of bone but mostly of muscle
A
abdomen
14
Q
what are the skeletal components of the abdomen?
A
5 lumbar vertebrae, superior parts of pelvic bones, ribs XII and XI and xiphoid process
15
Q
what are the muscles of the abdomen?
A
- quadratus lumborum
- psoas major
- iliacus
- transverse and rectus abdominus
- internal and external obliques
16
Q
suspended from the posterior wall of the abdominal cavity by the dorsal (posterior) mesentery
A
The gut tube (gastrointestinal system)
17
Q
partly suspended from the anterior wall by the ventral (anterior) mesentery
A
Proximal regions of the gut tube
18
Q
- lined with peritoneum
- It reflects off the wall and onto the organs forming parietal peritoneum (abdominal walls) and visceral peritoneum (covers suspended organs)
A
abdominal cavity
19
Q
found suspended from abdominal walls by mesenteries
A
Intraperitoneal structures
20
Q
are not suspended but lie between the parietal peritoneum and abdominal wall
A
Retroperitoneal structures
21
Q
- the inferior thoracic aperture
- enclosed by the diaphragm
A
The superior thoracic aperture of the abdomen
22
Q
- attached to median, medial, and lateral arcuate ligaments
- attaches to the vertebral column via left and right crus
A
diaphragm
23
Q
continuous with the abdominal cavity at the pelvic inlet
A
pelvic cavity
24
Q
- formed entirely of bone
- Formed by: sacrum, pubic symphysis, bony rim of pelvic bone
A
pelvic inlet
25
why are the abdominal and pelvic cavities not in the same plane?
- Because of the orientation of the pelvis relative to the vertebral column
- hips rotated up
26
connects to the thoracic cavity, pelvic cavity, and lower limbs
abdominal cavity
27
continuous between abdominal and pelvic cavities
peritoneum
28
communicates with the lower limb through an aperture formed by the inguinal ligament, inferior abdominal wall, and pelvic bone
abdominal cavity
29
what structures pass through the aperture that the abdominal cavity communicates with the lower limb through?
- major arteries and veins
- femoral nerve
- lymphatics
- distal ends of psoas major
- iliacus muscles
30
-begins as tube oriented longitudinally in the abdominal cavity
gut tube (developmentally)
31
suspended from the walls by anterior and posterior mesenteries
gut tube
32
what happens to the gut tube?
- Massive longitudinal lengthening
- rotation of selected parts
- secondary fusion to the abdominal wall
33
what forms during the development of the gut?
- The lesser and greater omentum form, the colon forms with certain parts becoming secondarily retroperitoneal
- The omental foramen and omental bursae are also formed
34
distal end of esophagus, stomach, and proximal part of duodenum
foregut
35
Distal end of duodenum, jejunum, ileum, ascending colon, and proximal 2/3 of transverse colon
midgut
36
distal 1/3 of transverse colon, descending colon, sigmoid colon, and superior part of rectum
hindgut
37
supply skin and muscle of the abdominal wall
Anterior rami of spinal nerves T7-T12
38
innervate upper parts of the external oblique
T5 and T6
39
innervated by L1 and not thoracic nerves
Skin and muscle in the inguinal and suprapubic regions
40
descend from their origin into the pelvic cavity in women and into the testis in men
gonads
41
passes though the anterior wall and attaches to the labioscrotal swelling before the descent of the gonads
-forms the processus vaginalis
gubernaculum
42
the passage though the abdominal wall formed by the processus vaginalis
inguinal canal
43
contains the spermatic cord, nerves, and vasculature associated with the testis
inguinal canal (of men)
44
the only structure to pass through the inguinal canal in women
a derivative of the gubernaculum (the round ligament of the uterus)
45
- a horizontal plane that transects through the lower aspect of vertebrae L1
- Midway between the jugular notch and pubic symphysis
- passes through the opening of the stomach into the duodenum, body of pancreas, hila of kidneys
The transpyloric plane
46
begins just left of the body of vertebra LII
jejunum
47
branch off the abdominal aorta to supply gastrointestinal tract
* *3 large unpaired arteries
- celiac artery
- superior messenteric artery
- inferior messenteric artery
48
supplies the foregut
celiac artery
49
supplies mid gut
Superior mesenteric artery
50
supplies hindgut
Inferior mesenteric artery
51
lies to the right of the vertebral column so blood must be shunted to the right from the left
inferior vena cava
52
what are the veins that cross the midline?
- left renal
- left common iliac
- left lumbar
53
passes through the liver
Blood draining the gastrointestinal system and spleen
54
takes blood into the liver from the gastrointestinal system and spleen
hepatic portal vein
55
take blood from the liver into the inferior vena cava
hepatic veins
56
overlap between portal and caval systems occurs around the inferior end of esophagus and inferior end of rectum
Portacaval anastomes
57
innervated by the prevertebral plexus
Abdominal viscera
58
- Found on the anterior and lateral sides of the aorta
| - Branches follow vessels that come off the aorta
prevertebral plexus
59
- bounded superiorly by the diaphragm and inferiorly by the pelvic inlet
- contains the peritoneal cavity
- continuous with pelvic cavity
abdominal cavity
60
a potential space between the parietal and visceral peritoneum
peritoneal cavity
61
**divides the abdomen into: right upper, left upper, right lower, left lower quadrants
-Pain in any of these
quadrants can be
associated with
abdominal organs
four quadrant system
62
divides the abdomen into: right hypochondrium, epigastric, left hypochondrium, right flank, umbilical, left flank, right groin, pubic region, left groin
the 9 region system
63
Bounded by the xiphoid process, costal margins, vertebral column, upper parts of pelvic bones
abdominal wall
64
consist of skin, superficial fascia, muscles, deep fascia, extraperitoneal fascia, parietal peritoneum
layers of abdominal wall
65
continues over the penis, continues into the scrotum and continues into the thigh below the inguinal canal
deeper membranous layer of the fatty layer
66
formed when the deeper membranous layer passes onto the penis
superficial penile fascia
67
formed when the deeper membranous layer passes into the scrotum
dartos fascia
68
what are the 5 muscles that make up the anterolateral group?
* *3 flat muscles that run anterolaterally and end in an aponeurosis toward the midline
- external oblique
- internal oblique
- transverse abdominus muscles
* *2 vertical muscles near the midline
- abdominus muscle
- pyramidalis muscle
69
form a firm but flexible wall that protects the organs of the abdominal cavity
anterolateral muscles
70
has fibers that run anteromedially, with its aponeurotic fibers covering the anterior part of the abdominal wall to the midline
external oblique
71
forms the inguinal ligament, lacunar ligament, and pectineal (Cooper’s) ligament
lower border of external oblique aponeurosis
72
- thinner layer that has fibers that run superomedially
| - Anterior fibers end as an aponeurosis that blends with the linea alba
internal oblique
73
- deep to the internal oblique
| - fibers run in a transverse (horizontal) direction and end anteriorly as an aponeurosis that blends with the linea alba
transverse abdominus
74
extends the length of the abdomen and is divided by tendinous intersections
rectus abdominus
75
small and often absent and have their base on the pubis
Pyramidalis muscles
76
deep to all muscles
Transversalis fascia
77
surrounded by the rectus sheath
The upper ¾ of the rectus muscles
78
all aponeuroses move anteriorly, leaving the transversalis fascia immediately deep to the rectus muscles
The lower ¼ of the rectus muscles
79
- Deep to the transversalis fascia
- contains various amounts of fat and lines the abdominal cavity
- covers organs that are considered retroperitoneal and extends into the mesenteries
extraperitoneal fascia
80
innervated by T7-T12 and L1 spinal nerves
skin, muscle, and parietal peritoneum
81
give off their lateral cutaneous branches
T7-T11 intercostal nerves
82
branch off the intercostal nerves toward the midline and pierce the rectus abdominus muscle
Anterior cutaneous branches
83
subcostal nerve
T12 spinal nerve
84
gives off iliohypogastric and ilio-inguinal branches
Spinal nerve L1
85
innervate anterolateral muscles and underlying peritoneum and end by innervating over lying skin
all spinal nerves
86
occur at increasingly oblique angles in an inferior direction
dermatomes
87
innervate parts of the scrotum or labia majora and thigh
Branches off L1 spinal nerve (ilio-inguinal)
88
superficially: supplied by the musculophrenic;
superior part of abdominal wall
89
superficially: supplied by superficial epigastric and superficial circumflex iliac
inferior part of abdominal wall
90
deeper: supplied by superior epigastric
superior part of abdominal wall
91
deeper: supplied by 10th and 11th intercostal arteries and subcostal artery
lateral part of abdominal wall
92
deeper: supplied by inferior epigastric, deep circumflex iliac, and external iliac
inferior part of abdominal wall
93
both enter the rectus sheath posterior to the rectus abdominus and anastomose
Superior and inferior epigastric arteries
94
drains into axillary nodes
Lymphatic drainage above umbilicus
95
drains into the superficial inguinal nodes
Lymphatic drainage below umbilicus
96
drains into parasternal nodes
deep lymphatics
97
a peritoneal out-pocketing that protrudes through various layers of the abdominal wall and acquires covering from each
processus vaginalis
98
deepest covering of processes vaginalis
transversalis fascia
99
second deepest layer of processes vaginalis
muscular layer of the internal oblique
100
third deepest layer of processes vaginalis
aponeurosis of the external oblique
101
- a slit like passage running downward and medially, just superior and parallel to the inguinal ligament
- Begins at deep inguinal ring and ends at superficial inguinal ring
inguinal canal
102
- Contains the genitofemoral nerve and the spermatic cord in males
- has the round ligament in women
inguinal canal
103
- Beginning of the inguinal canal
- where the transversalis fascia evaginates to form the tubular internal spermatic fascia of the spermatic cord in males or the round ligament of the uterus in women
deep inguinal ring
104
- Forms the end of the inguinal canal
- It is a triangular evagination of the aponeurosis of the external oblique onto structures traversing the inguinal canal
- forms the external spermatic fascia
superficial inguinal ring
105
forms the anterior wall of the inguinal canal
The aponeurosis of the external oblique
106
- covers the deep inguinal ring
| - contributes a layer (cremastic fascia and muscle) to the structures traversing the canal
internal oblique
107
forms the posterior wall and is reinforced by the conjoint tendon along the medial 1/3
transversalis fascia
108
formed by the arching fibers of the transverse abdominus and internal oblique
roof of the inguinal canal
109
They pass from their common points of attachment on the inguinal ligament to common medial attachment as the conjoin tendon
arching fibers of the transverse abdominus and internal oblique
110
* ***Contains:
- Ductus deferens
- Artery of ductus deferens
- Testicular artery
- Pampiniform plexus of veins (testicular veins)
- Cremastic artery and vein
- Genital branch of genitofemoral nerve
- Sympathetic and visceral afferent nerves
- Lymphatics
- Remnants of processus vaginalis
spermatic cord
111
the protrusion of the peritoneal sac through a weakened part of the abdominal wall
inguinal hernia
112
protrusion of the peritoneal sac through the deep ring
inguinal hernia
113
usually due to some of the processus vaginalis remaining
indirect hernias
114
- occurs when the peritoneal sac enters the medial end of the inguinal canal
- Occurs in an area where abdominal muscles have been weakened
Direct inguinal hernia
115
lines the walls and viscera of the abdominal cavity
a thin membrane
116
either suspended in the abdominal cavity by mesenteries or are outside the peritoneal cavity
organs
117
divided into the greater sac and the omental bursa
peritoneal cavity
118
accounts for most of the space in the peritoneal cavity
greater sac
119
- a smaller subdivision of the peritoneal cavity posterior to the stomach and liver
- continuous with the greater sac through the omental (epiploic) foramen
omental bursa
120
arise from the dorsal and ventral mesenteries during development
Omenta, mesenteries, and ligaments
121
pass from the stomach and first part of the duodenum to other viscera
greater and lesser omenta
122
- a large double layered peritoneal apron-like fold that develops from the dorsal mesentery
- drapes down over the transverse colon and coils of the jejunum and ileum
- Contains right and left gastro-omental vessels
greater omentum
123
- extends from the lesser curvature of the stomach and 1st part of duodenum to the inferior surface of the liver
- Divided into the hepatogastric and hepatoduodenal ligament
lesser omentum
124
connects the ileum and jejunum to the posterior wall of the abdomen
mesentery
125
connects the transverse colon to the posterior wall
transverse mesocolon
126
connects the sigmoid colon to the abdominal wall
sigmoid mesocolon
127
lie in the fat between the 2 layers of peritoneum of the mesentary
the blood vessels and lymphatics that supply the ileum and jejunum
128
represents the short distal part in the abdominal cavity
abdominal esophagus
129
Associated with the esophagus as it enters the abdomen
the anterior and posterior vagal trunks
130
arises from the left vagus nerve
anterior vagal trunk
131
arises from the right vagus nerve
posterior vagal trunk
132
what is the arterial supply to the abdominal esophagus?
- esophageal branch of left gastric
| - esophageal branch from left inferior phrenic
133
- the most dilated part of the gastrointestinal tract
- found between the abdominal esophagus and the duodenum
- has 4 regions
the stomach
134
what are the 4 regions of the stomach?
- cardia
- fundus
- body
- pyloric part
135
surrounds opening of esophagus into stomach
cardia
136
area above the level of the cardial orifice
fundus
137
largest region of the stomach
body
138
distal end of stomach
pyloric part
139
- marked on the surface by the pyloric constriction
| - contains the pyloric sphincter which defines the pyloric orifice
pylorus
140
* **contains:
- pylorus
- greater & lesser curvatures
- cardial notch
- angular incisure
stomach
141
what is the arterial supply to the stomach?
- left gastric from celiac trunk
- right gastric from hepatic artery proper
- right gastro-omental
- left gastro-omental
- posterior gastric artery
142
Consists of duodenum, jejunum, and ileum
small intestine
143
- C-shaped and 20-25 cm long
- Divided in 4 parts: superior, descending, inferior, and ascending
- terminates at the dudenojejunal flexure
duodenum
144
contains the major duodenal papillae
descending part of duodenum
145
what is the blood supply to the duodenum?
ultimately arises from the celiac trunk and superior mesenteric
146
- makes up the proximal 2/5, has a larger diameter and thicker wall than the ileum
- has a unique vascular pattern associated with the mesentery
jejunum
147
- makes up the distal 3/5 and has thinner walls
| - opens into the large intestine near the cecum
ileum
148
project into the lumen of the large intestine and surround the opening
2 ileocecal flaps
149
what is the blood supply to the ileum?
- arteries from superior mesenteric artery
| - an ileal branch from the ileocolic artery
150
- Extends from the distal end of the ileum to the anus
| - characterized by omental appendices, haustra, and taenia coli
large intestine
151
Begins as the cecum and associated appendix, continues upward as the ascending colon, right colic flexure, transverse colon, left colic flexure, descending colon, sigmoid colon, rectum, anal canal
large intestine
152
- begins in the lower right regions and extends into the lateral, superior, and inferior regions
- centers as it enters the anus
colon
153
the first part of the colon and is inferior to the ileocecal opening
cecum
154
a narrow, hollow, blind-ended tube connects to the cecum and contains a large aggregation of lymphoid tissue
appendix
155
attached to the terminal end of the ileum via the mesoappendix which contains the appendicular vessels
appendix
156
the attachment of the appendix to the cecum is consistent with:..........
taeniae coli
157
location relative to the rest of the appendix varies:....
- Retrocecal
- Pelvic
- Subcecal
- Pre-ileal
- Postileal
158
what is the arterial supply of the cecum and appendix?
* *arterial supply arises from the superior mesenteric
- Giving rise:
- ileocolic
- anterior and posterior
- cecal arteries
- appendicular artery
159
ascending and descending parts of the colon
retroperitoneal
160
Transverse and sigmoid segments of the colon
intraperitoneal
161
Lateral to the ascending and descending segments
right and left paracolic gutters
162
supply the colon
superior and inferior mesenteric arteries
163
- gives rise to the ileocolic, right colic, and middle colic
| - supplies the ascending and transverse segments of colon
superior mesenteric
164
gives rise to the left colic, sigmoid arteries, and superior rectal artery
inferior mesenteric
165
extends from the sigmoid colon
rectum
166
a continuation of the large intestine inferior to the rectum
anal canal
167
what is the blood supply to the rectum and anal canal?
- superior rectal artery (from inferior mesenteric)
- middle rectal artery (from internal iliacs)
- inferior rectal artery (from pudendal artery)
